Nursing Elites

1. A 50-year-old woman has had a relapse of her multiple sclerosis (MS) after several years of being symptom-free. Which of the following factors is most likely to have contributed to her relapse?

• A. Emotional stress
• B. Dietary indiscretion
• C. Physical overexertion
• D. Adequate rest and relaxation

Correct answer: C

Rationale: The correct answer is C: Physical overexertion. In individuals with multiple sclerosis (MS), physical overexertion can exacerbate symptoms and contribute to a relapse. It is important for individuals with MS to balance physical activity to avoid triggering symptom reoccurrence. Choices A, B, and D are less likely to have directly contributed to the relapse. Emotional stress and dietary indiscretion may play a role in exacerbating symptoms in some individuals, but physical overexertion is more commonly associated with MS relapses. Adequate rest and relaxation are important for overall well-being but are not typically linked to MS relapses.

2. What common symptom should be assessed in individuals with immunodeficiency?

• A. Anemia
• B. Recurrent infections
• C. Hypersensitivity
• D. Autoantibody production

Correct answer: B

Rationale: Recurrent infections are a hallmark symptom of immunodeficiency. Individuals with impaired immune systems are more susceptible to recurrent infections due to their compromised ability to fight off pathogens. Anemia (Choice A) is not a direct symptom of immunodeficiency but can be a consequence of chronic diseases. Hypersensitivity (Choice C) refers to exaggerated immune responses rather than impaired immune function. Autoantibody production (Choice D) is not typically a primary symptom of immunodeficiency but may be seen in certain autoimmune conditions.

3. Which of the following disturbances would cause a client to experience gout?

• A. Serotonin receptors
• B. Uric acid metabolism
• C. Liver function
• D. Cardiac function

Correct answer: B

Rationale: Gout is caused by a disturbance in uric acid metabolism, leading to the accumulation of uric acid crystals in joints. Serotonin receptors (Choice A) are not related to gout. Liver function (Choice C) is important for metabolism but is not directly linked to gout development. Cardiac function (Choice D) is primarily related to the heart's functioning and not associated with gout.

4. A school nurse is meeting with a high school student who mentions that she is frustrated with her repeated outbreaks of cold sores. The student states that she tried an over-the-counter topical cream but that it failed to produce an appreciable improvement. The nurse should recognize that this student used what medication?

• A. Ganciclovir
• B. Valacyclovir (Valtrex)
• C. Famciclovir (Famvir)
• D. Docosanol (Abreva)

Correct answer: D

Rationale: The correct answer is D: Docosanol (Abreva). Docosanol is an over-the-counter topical cream commonly used to treat cold sores caused by the herpes simplex virus. It works by inhibiting viral fusion to host cell membranes, reducing the spread of the virus. Ganciclovir (Choice A) is an antiviral medication used for the treatment of cytomegalovirus infections. Valacyclovir (Choice B) and Famciclovir (Choice C) are prescription antiviral medications used to treat herpes simplex virus infections but are not typically available over-the-counter like Docosanol.

5. A client with a pneumothorax is receiving oxygen therapy. Which assessment finding would indicate that the treatment is effective?

• A. Increased respiratory rate
• B. Decreased oxygen saturation levels
• C. Improved breath sounds on the affected side
• D. Increased dyspnea and chest pain

Correct answer: C

Rationale: In a client with a pneumothorax receiving oxygen therapy, improved breath sounds on the affected side would indicate effective treatment. This finding suggests that the collapsed lung is re-expanding, allowing air to flow more freely in and out of the affected area. Choices A, B, and D are incorrect: Increased respiratory rate, decreased oxygen saturation levels, and increased dyspnea and chest pain are signs of ineffective treatment or worsening of the condition in a client with a pneumothorax.

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